The Approaching The Obese Patients In Dentistry

Yıl 2012, Cilt: 2012 Sayı: 3, 317 - 324, 01.03.2012

Araş. Gör. Dt. Oğuz Köse Prof. Dr. Varol Çanakçı Yard. Doç. Dr. Taner Arabacı

Öz

-

Anahtar Kelimeler

Obesity, Overweight, Dentist

Diş Hekimliğinde Obez Hastalara Yaklaşım

Öz

Obezite ve aşırı kilo vücut sağlığını bozacak ölçüde yağ dokusundaki anormal veya aşırı yağ birikmesi olarak tanımlanmaktadır. Obezitenin ve aşırı kilonun temel nedeni, diyetle alınan enerji miktarı ile metabolizma ve fiziksel aktiviteler sırasında harcanan enerji miktarı arasındaki düzensizliktir. Aşırı kilo ve obezite prevalansı dünyanın çeşitli bölgelerindeki gelişmiş ve gelişmekte olan ülkelerde ciddiyetle dikkate alınması gereken oranlara ulaşmıştır. Obezite başta Tip 2 diyabet, hipertansiyon ve kardiyovasküler sistem hastalıkları olmak üzere pek çok kronik enflamatuar hastalık ve kanser gelişimi için temel bir risk faktörü olarak kabul edilmektedir. Son dönemdeki çalışmalar obezitenin ağız hastalıkları, özelliklede periodontitis ile ilişkili olduğunu göstermiştir. Bunun yanı sıra çürük, diş kaybı, travmatik diş yaralanmaları, ağız kuruluğu ile de ilişkilidir. Obezite prevalansının dünya çapında bir artış eğiliminde olması, diş hekimi kliniklerinde obez hastalarla çok daha sık karşılaşılması ihtimalini artırmaktadır. Kliniğe ulaşım imkânları ve tedavi ortamının ergonomisi obez hastalar için bazı modifikasyonlar gerektirebilir. Hastanın muayenesi, tedavi için hazırlanması, konservatif veya cerrahi müdahaleler ve ilaç tedavisi aşamaları obez hastalarda bazı spesifik yaklaşımları gerektirmektedir. Bu derlemede diş hekiminin obez hastalara yaklaşımına yardımcı olabilecek bilgilerin güncel literatürler ışığında değerlendirilmesi amaçlanmaktadır

Anahtar Kelimeler

-

Kaynakça

• Selassie M, Sinha AC. The epidemiology and aetiology of obesity: A global Challenge. Best Practice & Research Clinical Anaesthesiology 2011; 25: 1–9.
• World Health Organization. Obesity. 2008. Available at:http://www.who.int/topics/obesity/en/
• Kopelman PG. Obesity as a medical problem. Nature 2000; 404: 635–643.
• Doll S, Paccaud F, Bovet P, Burnier M, Wietlisbach V. Body mass index, abdominal adiposity and blood pressure: consistency of their association across developing and developed countries. Int J Obes Relat Metab Disord 2002; 26: 48–57.
• Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH. The disease burden associated with overweight and obesity. JAMA 1999; 282: 1523– 1529.
• Field AE, Coakley EH, Must A, Spadano JL, Laird N, Dietz WH, Rimm E, Colditz G. Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Arch Intern Med 2001; 161: 1581–1586.
• Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH. The disease burden associated with overweight and obesity. JAMA 1999; 282: 1523– 1529.
• Kuczmarski RJ, Flegal KM, Campbell SM, Johnson CL. Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys, 1960–1991. JAMA 1994; 272: 205–211.
• Saw SM, Rajan U. The epidemiology of obesity: a review. Ann Acad Med Singapore 1997; 26: 489– 493. 10.World Health Organization. http://www.who.int/mediacentre/factsheets/fs311/ en/index.html (Erişim tarihi: 21.12.2011) 11.World Health Organization. www.who.int/bmi/index.jsp 18.12.2011) (Erişim tarihi:
• Kumanyika SK, Obarzanek E, Stettler N, Bell R, Field AE, Fortmann SP, Franklin BA, Gillman MW, Lewis CE, Poston WC, Stevens J, Hong Y. Population-based prevention of obesity: the need for comprehensive promotion of healthful eating, physical activity, and energy balance: a scientific statement from American Heart Association Council on Epidemiology and Prevention, Interdisciplinary Committee for Prevention (formerly the expert panel on population and prevention science). Circulation 2008: 118(4):428-464
• National Heart, Lung and Blood Institute. Clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults – the evidence report. Obes Res 1998; 6: 1-78 14.World Health
• Organization/International
• Association for the Study of Obesity/International
• Obesity Takforce. The Asia-Pacific perspective:
• redefining obesity and its treatment. Available at:
• http://www.idi.org.au/obesity report.htm.
• N. Pischon, N. Heng, J.-P. Bernimoulin, B.-M. Kleber, S.N. Willich and T. Pischon. Obesity, Inflammation, and Periodontal Disease. J Dent Res 2007; 86: 400.
• Perlstein MI, Bissada NF. Influence of obesity and hypertension on the severity of periodontitis in rats. Oral Surg Oral Med Oral Pathol 1977; 43: 707-719.
• Saito T, Shimazaki Y, Sakamoto M. Obesity and periodontitis. N Engl J Med 1998; 339:482-483.
• Saito T, Shimazaki Y, Koga T, Tsuzuki M, Oshima A. Relationship between upper body obesity and periodontitis. J Dent Res 2001; 80: 1631-1636.
• Saito T, Shimazaki Y, Kiyohara Y, Kato I, Kubo M, Lida M, Yamashita Y. Relationship between obesity, glucose tolerance, and periodontal disease in Japanese women: the Hisayama study. J Periodontal Res 2005; 40: 346-353.
• Al-Zahrani MS, Bissada NF, Borawskit EA. Obesity and periodontal disease in young, middle-aged, and older adults. J Periodontol 2003; 74: 610- 615.
• Wood N, Johnson RB, Streckfus CF. Comparison of body composition and periodontal disease using nutritional assessment techniques. Third National Health and Nutrition Examination Survey (NHANES III). J Clin Periodontol 2003; 30: 321-327.
• Dalla Vecchia CF, Susin C, Rösing CK, Oppermann RV, Albandar JM Overweight and obesity as risk indicators for periodontitis in adults. J Periodontol 2005; 76: 1721-1728.
• Genco RJ, Grossi SG, Ho A, Nishimura F, Murayama Y. A proposed model linking inflammation to obesity, diabetes, and periodontal infections. J Periodontol 2005; 76(11): 2075-2084.
• Brooks CMY, Roldan R. Relationship between early childhood caries and obesity. J Dent Res 2004; 83: 765.
• Marshall TA, Eichenberger-Gilmore J, Broffitt B, Levy S, Cunningham M, Warren JJ. Measures of childhood obesity and caries experience at 5 years. J Dent Res 2005; 84: 801.
• Hu WC, Ho YT, Huang ST. Relationship between obesity and oral status of children in Taiwan. J Dent Res 2004; 83: 154
• Larsson B, Johansson I, Hallmans G, Ericson T. Relationship between dental caries and risk factors for atherosclerosis in Swedish adolescents. Community Dent Oral Epidemiol 1995; 23: 205- 210.
• Tuomi T. Pilot study on obesity in caries prediction. Community Dent Oral Epidemiol 1989; 17: 289-291.
• Goldsleger S, Tinanoff N, Watson MR. Potential association of mothers’ obesity and early childhood caries. J Dent Res 2002; 81: 138.
• Sheiham A, Steele JG, Marcenes, Finch S, Walls AW. The relationship between oral health status and body mass index among older people: a national survey of older people in Great Britain. Br Dent J 2002; 192: 703-706.
• Forslund HB, Lindroos AK, Blomkvist K, Hakeberg M, Berggren U, Jontell M, Torgerson JS. Number of teeth, body mass index, and dental anxiety in middle-aged Swedish women. Acta Odontol Scand 2002; 60: 346-352.
• Johansson I, Tidehag P, Lundberg V, Hallmans G. Dental status, diet and cardiovascular risk factors in middle-aged people in northern Sweden. Community Dent Oral Epidemiol 1994; 22: 431- 436.
• Wolk A, Rossner S. Obesity and self-perceived health in Sweden. Int J Obes Relat Metab Disord 1996; 20: 369-372.
• Petti S, Cairella G, Tarsitani G. Childhood obesity: a risk factor for traumatic injuries to anterior teeth. Endod Dent Traumatol 1997; 13: 285-288.
• Soriano EP, Caldas AF, Goes PS. Risk factors related tot traumatic dental injuries in Brazilian schoolchildren. Dent Traumatol 2004; 20: 246-250.
• Nicolau B, Marcenes W, Sheiham A. Prevalence, causes and correlates of traumatic dental injuries among 13-year-olds in Brazil. Dent Traumatol 2001; 17: 213-217.
• Perheentupa U, Laukkanen P, Veijola J, Joukamaa M, Jarvelin MR, Laitinen J, Oikarinen K. Increased lifetime prevalence of dental trauma is associated with previous non-dental injuries, mental distress and high alcohol consumption. Dent Traumatol 2001; 17: 10-16.
• Moore LL, Singer MR, Bradlee ML, Rothman KJ, Milunky A. A prospective study of the risk of congenital defects associated with maternal obesity and diabetes mellitus. Epidemiology 2000; 11: 689-694.
• Queisser-Luft A, Kieninger-Baum D, Menger H, Stolz G, Schlaefer K, Merz E. Does maternal obesity increase the risk of fetal abnormalities? Analysis of 20,248 newborn infants of the Mainz Birth abnormalities. Ultraschall Med 1998; 19: 40-44.
• Cedergren M, Källen B. Maternal obesity and the risk for orofacial clefts in the offspring. Cleft Palate Craniofac J 2005; 42: 367-371.
• Linne Y, Rossner S. What is "obesity"—an analysis of referral letters to an obesity unit. Int J Obes Relat Metab Disord 1998; 22: 1231-1233.
• Cleator J, Richman E, Leong KS, Mawdsley L, White S, Wilding J. Obesity: under-diagnosed and under-treated in hospital outpatient departments. Int J Obes Relat Metab Disord 2002; 26: 581-584.
• Caccamese SM, Kolodner K, Wright SM. Comparing patient and physician perception of weight status with body mass index. Am J Med 2002; 112: 662- 666.
• Chacon GE, Viehweg TL, Ganzberg SI. Management of the obese patient undergoing office-based oral and maxillofacial surgey procedures. J Oral Maxillofac Surg 2004; 62: 88- 93.
• Marciani RD, Raezer BF, Marciani HL. Obesity and the practice of oral and maxillofacial surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 98: 10-15.
• Magliocca KR, Helman JI. Obstructive sleep apnoea. Diagnosis, medical management and dental implications. J Am Dent Assoc 2005; 136: 1121-1129
• Reilly D, Boyle CA, Craig DC. Obesity and dentistry: a growing problem. British dental journal 2009; 207: 171-175
• Kempers KG, Foote JW, DiFlorio-Brennan T. Obesity: prevalence and considerations in oral and maxillofacial surgery. J Oral Maxillofac Surg 2000; 58: 137-143.
• Touger-Decker R, Mobley CC. Position of the American Dietetic Association: oral health and nutrition. J Am Diet Assoc 2003; 103: 615-625.
• Wilson JA, Clark JJ. Obesity: impediment to postsurgical wound healing. Adv skin wound care 2004; 17: 426-435.
• Armstrong M. Obesity as an intrinsic factor affecting wound healing. J Wound Care 1998; 7: 220-221.
• Field AE, Coakley EH, Must A. Impact of overweight on the risk of developing common chronic diseases during a 10- year period. Arch Int Med 2001: 161: 1581–1586.
• Huang, Z, Willett WE, Manson JE, Rosner B, Stampfer MJ, Speizer FE. Body weight, weight change, and risk for hypertension in women. Ann Intern Med 1998: 128: 81–88.
• Adams JP, Murphy PG. Obesity in anaesthesia and intensive care. Br J Anaesth 2000; 85: 91-108.
• Constantino TG, Parikh AK, Satz WA, Fojtik JP. Ultrasonography-guided peripheral intravenous access versus traditional approaches in patients with difficult intravenous access. Ann Emerg Med 2005; 46: 456-461.
• Magliocca KR, Helman JI. Obstructive sleep apnea. diagnosis, medical management and dental implications. J Am Dent Assoc 2005; 136: 1121– 1129.
• Roman KM. The overweight child in the dental chair: risk management considerations. J N J Dent Assoc 2003; 74: 34-35.
• World Health Organisation. Obesity: preventing and managing the global epidemic – results of a WHO WHO/NUT/NCD/98.1, 1998;1-276. on obesity. Geneva,
• National Institutes of Health, National Heart, Lung and Blood Institute. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults – the evidence report. Obes Res 1998; 6(2): 51-210.
• McTigue KM, Harris R, Hemphill B, Lux L, Sutton S, Bunton interventions for obesity in adults: summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2003; 139: 933-949. and
• Yanovski SZ, Yanovski JA. Obesity. N Engl J Med 2002; 346: 591-601.
• Wynn RL. Sibutramine (Meridia)- dental considerations for a new weight control drug. Gen Dent 1998; 46: 332-335.
• Boyd LD, Dwyer JT, Papas A. Nutritional implications of xerostomia and rampant caries caused by serotonin reuptake inhibitors: A case study. Nutr Rev 1997; 55: 362-368.
• Heling I, Sgan-Cohen HD, Itzhaki M, Beglaibter N, Avrutis O, Gimmon Z. Dental complications following gastric restrictive bariatric surgery. Obes Surg 2006; 16: 1131-1134.
• Kark AE. Jaw wiring. Am J Clin Nutr 1980; 33: 420-424.
• Harding PE. Jaw wiring for obesity. Lancet 1980; 1: 534-535.
• Castelnuovo-Tedesco P, Buchanan DC, Hall HD. Jaw-wiring for obesity. Gen Hosp Psychiatry 1980; 2: 156-159.
• Lieber CP, Seinige UL, Stataloff DM, Blake HA, Rovito PF. Temporary intervention: dental splinting and the intragastric bubble. Gastroenterol Clin North Am 1987; 16: 451-460.
• Moskowitz EM. The limits of dentistry. N Y State Dent J 2004: 70: 3